The pH-dependent solubility of
an ionizable compound is traditionally calculated in GI-Sim according to the Henderson–Hasselbalch equation and the physiological pH in each GI compartment. However, since the gastric solubility was measured in this study, both gastric and intestinal in vitro values were used as input in the simulations. In GI-Sim, dissolution rate is described by Fick’s law together with the Nielsen stirring VE-821 mouse model (Nielsen, 1961). Effective permeability describes the absorption and total membrane transport process that involves serial diffusion through an aqueous boundary layer adjacent to the intestinal wall and the intestinal membrane. Absorption generally occurs in all GI compartments except the stomach. In this study we were interested in the effect on immediate release formulations of highly permeable compounds i.e., class 2 compounds in the biopharmaceutics classification system (BCS). These are poorly soluble and highly permeable and SKI-606 clinical trial therefore the simulations only modeled absorption from the small intestinal compartments (compartments 2–7 in GI-Sim). Specific solubility factors, obtained from the in vitro measurements, were implemented to account for the effect of ethanol on the solubility of the investigated compounds. FaSSGF20%Ethanol and FaSSIF20%Ethanol measurements were used for the stomach (GI compartment 1) and duodenum (GI compartment 2), respectively, in simulations
of concomitant intake of ethanol. The simulations used the maximum oral doses prescribed. Two particle sizes Methisazone were investigated to study their impact on the resulting dissolution. The first had a generic particle size with a diameter of 25 μm (d10 = 12.5 μm, d50 = 25 μm, d90 = 50 μm). A second particle size fraction with diameter of 5 μm (d10 = 2.5 μm, d50 = 5 μm, d90 = 10 μm) was studied to represent micronized powder. Default simulation time was set to 8 h. If the absorption was incomplete, the simulation was repeated with a longer simulation time, up to 24 h, to capture the entire absorption phase. In a second step, the simulations were
repeated for compounds with a predicted 15% increase in AUC due to the ethanol effects. These further simulations were performed with ethanol only present in the stomach to investigate if an extraordinarily rapid absorption of ethanol from the duodenum still had the possibility to increase plasma drug concentration. The low pH of the gastric media resulted in high Sapp values for cinnarizine, dipyridamole and inhibitors terfenadine as a consequence of the complete ionization of these weak bases ( Table 3). Indomethacin, indoprofen and tolfenamic acid are weak acids with pKa values > 3.9 ( Fagerberg et al., 2012); therefore at pH 2.5, they are predominantly neutral. This is reflected in the low Sapp in NaClpH2.5. The Sapp of the neutral compounds – felodipine, griseofulvin and progesterone – in the NaCl solution was also low, less than 15 μg/mL ( Table 3).
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